23 year old male with paraparesis:

23 year old male with paraparesis:

 I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan. 
You can find patient clinical data in this link here- https://vaish7.blogspot.com/2020/05/medicine.html?m=1exae
Chief complaints:
*weakness of bilateral lower limbs since 5 days.
*Associated with tingling and numbness.
*Vomitting 5 days back
-non projectile
- nonbilious
- content - food particles
* Suddenly fall when he got up for urination.
*Gluteal abscess since 5 months
*Scrotal abscess since 20 days.
Anatomical location of the cause: 
Cause of paraparesis may lies in anterior right and left cerebral hemispheres and pyramidal tract.
Ethiology of the cause:
On MRI examination - disseminated tuberculosis as there is ring enhancing lesions in brain.
So,in this patient,  the bacteria may spread from lumbosacral abscess  to blood and from blood it may reach brain through circle of willis and cause paraparesis
Probable diagnosis:
Paraparesis with L4,L5infective spondylodiscitis with left psoas abscess with ring enhancing lesions in right and left cerebral hemispheres with healing ulcer in right gluteal region secondary to drained gluteal abscess with pyocele left side operated ( 10 days back)
Treatment
 *T.ATT 3 tabs/day fdc
 *T.Benadon 40mg/od
 *T.pregabalin 75mg/po/h/s


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